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Lastly, indirect nutrition strategies, such as malaria prevention, preconception care, water, sanitation, and hygiene promotion, delivered inside and outside the health-care sector also provide important nutritional benefits. Looking forward, greater effort is required to improve intervention coverage, especially for the most vulnerable, and there is a crucial need to address the growing double burden of malnutrition (undernutrition, and overweight and obesity) in LMICs.Objectives This study evaluated multiple computed tomography (CT) workforce models to identify any implications on efficiency (length of stay, scan frequency and workforce cost) and scanning radiographer interruptions through substituting or supplementing with a trained CT assistant. Methods The study was conducted in a CT unit of a tertiary Queensland hospital and prospectively compared four workforce models, including usual practice Model 1 used an administrative assistant (AA) and one radiographer; Model 2 substituted a medical imaging assistant (MIA) for the AA; Model 3 was usual practice, consisting of two radiographers; and Model 4 included two radiographers, with a supplemented MIA. Solutol HS-15 nmr Observational data were collected over 7 days per model and were cross-checked against electronic records. Data for interruption type and frequency, as well as scan type and duration, were collected. Annual workforce costs were calculated as measures of efficiency. Results Similar scan frequency and parameters (complexity) ficiency and interruptions, potentially affecting staff stress and burnout. In addition, the assistant's scope and accepted level of interruptions should be considerations when choosing the most appropriate model.This study developed an in-field analytical technique for food samples by integrating filtration into a surface-enhanced Raman spectroscopy (SERS) microchip. This microchip embedded a filter membrane in the chip inlet to eliminate interfering particulates and enrich target analytes. The design and geometry of the channel were optimised by finite-elemental method (FEM) to tailor variations of flow velocity (within 0-24 μL/s) and facilitate efficient mixing of the filtrate with nanoparticles in two steps. Four pesticides (thiabendazole, thiram, endosulfan, and malathion) were successfully detected either individually or as a mixture in strawberries using this sensor. Strong Raman signals were obtained for the four studied pesticides and their major peaks were clearly observable even at a low concentration of 5 µg/kg. Limits of detection of four pesticides in strawberry extract were in the range of 44-88 μg/kg, showing good sensitivity of the sensor to the target analytes. High selectivity of the sensor was also proved by successful detection of each individual pesticide as a mixture in strawberry matrices. link2 High recoveries (90-122%) were achieved for the four pesticides in the strawberry extract. This sensor is the first filter-based SERS microchip for identification and quantification of multiple target analytes in complex food samples.Background For newborns requiring transfer to a higher level of care, stabilization before the arrival of the transport team is essential. Telemedicine consultations with a neonatologist may improve local providers' ability to stabilize a newborn during this critical interval. The purpose of this study was to describe the use of telemedicine for stabilizing newborns who were transferred from one of six rural hospitals to a regional neonatal intensive care unit in northern California and to examine the association between telemedicine use and time needed to stabilize the newborn. Materials and Methods We collected data on all newborns who were transferred after either a telemedicine or telephone consultation with a neonatologist between April 2014 and June 2018. We used multiple regression to examine the association between the use of telemedicine and stabilization time, adjusting for gestational age, 5-min Apgar score, birth weight, site, and primary reason for consultation. Results In total, 162 infants (77.5%) received a telephone consultation and 47 (22.5%) received a telemedicine consultation. Neonates who received telemedicine had a significantly greater severity of illness, as measured by mean 5-min Apgar score (6.9 vs. 7.8, p = 0.008) and Transport Risk Index of Physiologic Stability version II (TRIPS-II) score (14.4 vs. link3 6.0, p less then 0.001). There was no significant difference in stabilization time for telemedicine consultations compared with telephone consultations in the adjusted analysis (adjusted mean difference -1.80, 95% confidence interval -16.0 to 12.4, p = 0.802). Conclusions Although we found no difference in stabilization times between modes of consultation, telemedicine may be helpful for stabilizing infants with a higher severity of illness, particularly those in respiratory distress. Future studies should examine the impact of telemedicine on specific interventions.Background Social media is a source of weight loss information for adolescents. However, engagement with image-based social media has been associated with reduced body image. This study describes weight loss imagery visible on an adolescent Instagram account. Methods The "top" 600 images were captured from "#weightloss" on an adolescent (16 years, gender not specified) Instagram account in August 2020. Images were categorized and coded based on a predetermined ontology as food (nutrient-dense, energy-dense), people (group, individual, before/after), or text-focused by one coder (20% in duplicate, 90% agreement). Images of people were coded for sex and ethnicity and images of individuals coded for adiposity, muscularity, and pose. Results Of 600 images, 208 (34.7%) were of individuals, predominantly females (83%) with white (37%), non-white (23%), or unclear (41%) ethnicity. Body types were thin (31%), average (43%), or higher weight (6%) with little-to-none (25%), visible (26%), or high (7%) muscularity. Almost half of images accentuated body features with a fitness/muscle accentuating (21%) or sexualized (21%) pose or both (3%). From 165 (27.5%) food images, 71% were nutrient-dense and 29% energy-dense. Of 107 (17.8%) before/after images, 90% depicted weight loss, 4% muscle building with 85% in females. From 93 (15.5%) text-focused images, 46% related to weight loss programs/products and few provided nutrition (n = 12, 13%) or exercise (n = 2, 2%) information. Conclusions Most "#weightloss" imagery visible to adolescents on Instagram were of people, frequently females, with almost half of body-focused poses or before/after weight loss images. Few provide nutrition and exercise-related content.Background The innovative telemedicine robotic remote-presence technology offers a promising solution to confront the challenges faced by health care personnel during events of mass gatherings by consulting expertise from offsite settings. Objective To assess knowledge, attitude, and perceptions of health care personnel (physicians and nurses) toward telemedicine robotic remote-presence technology, at the intensive care units (ICUs) of hospitals serving mass gathering. Methods The primary sampling unit included physicians and nurses using the sophisticated technology of telemedicine with robotic presence at the ICUs of Mina hospitals. An electronic invitation containing the survey tool was sent to all the participants from the four selected hospitals. Mean scores for knowledge and attitude questions were based on Likert scale responses. Result The study received a final sample of 140 valid and complete responses. The findings showed overall positive attitude, but the knowledge was limited. On a maximum score of 5, the mean knowledge and attitude scores obtained were 2.55 and 3.51. The participants expressed strong agreement in using technology to seek expert opinion, increase communication among providers, and improve clinical decisions, which is an essential factor during mass gatherings. However, concerns about patient privacy and confidentiality were raised. Lack of training and insufficient knowledge regarding telemedicine and robotic systems' applications were identified as significant barriers, followed by issues related to equipment malfunction. Conclusion Reinforcing continuous training programs to the health care staff to maximize the potential benefits of the innovative technology is suggested.

Telemedicine has shown promising results in the follow up of patients with inflammatory bowel disease. This study compared quality of life and disease activity in patients with inflammatory bowel disease monitored using a telemedicine platform versus standard care.

In this prospective multicenter study, patients with active inflammatory bowel disease were randomized to EasyMICI-MaMICI

telemedicine platform or standard care. The main objective was to assess the efficacy of the software platform, as measured by quality of life and quality of care. Secondary outcomes were changes in the use of healthcare resources, and patient satisfaction in the MaMICI group.

Fifty-four patients were enrolled (November 2017-June 2018); 59.3% had Crohn's disease and 40.7% ulcerative colitis. Forty-two patients received biologics at inclusion. After 12 months, a significant improvement in quality of life was observed with MaMICI versus standard care, with mean (standard deviation) changes from baseline of 14.8 (11.8) vs 6.3 (9.7) in the SIBDQ scores and 18.5 (18.7) vs 2.4 (8.3) in the EuroQol 5 D-3L questionnaire scores (both

 ≤ .02). Disease activity was similar in both treatment groups. Use of MaMICI slightly reduced healthcare utilization versus controls (mean gastroenterologist consultations 2.2 vs 4.1;

 = .1308). Overall satisfaction with MaMICI was high (mean score 7/10), and 46.2% of remaining patients in the MaMICI group continued to use the platform until 12 months.

Significant improvement in quality of life and overall satisfaction with this telemedicine platform, indicates that further evaluation of EasyMICI-MaMICI in larger numbers of patients with inflammatory bowel disease is warranted.

Significant improvement in quality of life and overall satisfaction with this telemedicine platform, indicates that further evaluation of EasyMICI-MaMICI in larger numbers of patients with inflammatory bowel disease is warranted.Background While teledermatology is well-established in the Department of Veterans Affairs (VA), its implementation is far from complete. To facilitate consultative teledermatology and extend its reach, VA introduced a mobile teledermatology application (app) at three VA sites. Methods We evaluated the initial implementation process using a mixed-methods, multiple case study approach to assess organizational readiness for change (ORC), which included examining facilitators, barriers, and contextual factors that affected implementation. We conducted (1) group interviews and bimonthly reports to understand site processes; (2) semistructured interviews and surveys of individual participants representing a range of implementation roles; and (3) a review of internal organizational documents. We identified themes from interviews using an iterative process, and computed an ORC score based on surveys. Results Forty-three individuals participated in the study. Qualitative data from all sites, corroborated by survey data available from one site, revealed a high readiness for change with an ORC score of 4.